April Blevins, 35, photographed Sept. 3, was working as a Bardstown, Ky. bus driver when severe bipolar disorder struck in 2007. / Michael Clevenger/ The Courier-Journal

Written by

Chris Kenning and Laura Ungar

The (Louisville, Ky.) Courier-Journal

LOUISVILLE, KY — April Blevins was working as a bus driver in Bardstown, Ky., when severe bipolar disorder turned her life upside down in 2007.

She had to leave her job and couldn't get insurance for nearly a year. When she finally got insurance through her husband's employer, her coverage was limited to 30 days of psychiatric hospital care a year and no more than five days in a row.

"I felt like they'd push me out the door in five days, whether I was ready or not," Blevins said. "After that you just try to deal with it as best you can, because you can't afford it. But you suffer, and your family suffers."

In Kentucky, Indiana and across the nation, access to insurance and limits on services, therapy visits and hospital stays have left those with mental illness feeling treated like second-class citizens in a health system built to handle physical ailments, according to patients, providers and advocates.

"If you treated oncology like you do behavioral health, you'd have people rallying in the streets," said Tony Zipple, chief executive officer at Seven Counties Services, the Louisville area's largest mental health provider.

But under the Affordable Care Act, also known as "Obamacare," insurers will soon be required to give mental illness coverage equal to that for physical ailments.

Starting next year, the ACA calls for one of the largest expansions of mental health and substance abuse coverage in a generation, requiring that all new small-group and individual market plans offer mental health services and cover them at a par with medical benefits.